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January 28, 2015 at 05:58 AM
An insurance actuary who has the misfortune to have relatively low-cost, unsubsidized medical insurance that complies with the Patient Protection and Affordable Care Act (PPACA) e-mailed me the other day to ask why she was so miserable. Why were her out-of-pocket costs were so high?
She (many details altered here to protect privacy) had just gone to an in-network hospital with a broken leg and came away with $5,000 in out-of-pocket bills.
Under her old plan, maybe she would have had $1,000 in bills.
She was arguing that those horrible bills were evidence of how PPACA has failed.
My argument would be that, however the many PPACA rules and programs might fail in other ways, any PPACA changes that pile as much of society’s health care market “skin in the game” on readers of LifeHealthPro.com — and anyone else who knows what a senate floor is or why someone might care about a health insurance policy’s lifetime out-of-pocket maximum — are good changes. Those are signs that something in PPACA worked properly.
On the one hand, PPACA is more like a tourniquet that tries to keep the uninsured from bleeding to death than any other kind of acceptable solution. I personally dread the thought of having to deal with PPACA exchange coverage, or any other affordable, PPACA-compliant coverage, just as I dread the idea of having to subsist on MREs after a natural disaster.
On the other hand, we’re in this mess partly because our old solution to the gap between what our conscience demands and our actual generosity was to put poor people and sick people in a health care access lottery, with their ability to get any kind of acceptable care depending on the whims of doctors, hospitals and fate.
